Artisan Prosthetics LLC
Organization Active NPI Prosthetic/Orthotic Supplier · Phoenix, AZ
NPI 1265616643 · NPPES record last updated Jan 30, 2023
Key facts
- NPI
- 1265616643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Prosthetic/Orthotic Supplier 335E00000X
- Legal business name
- ARTISAN PROSTHETICS LLC
- Practice address
- 4501 N 32ND St
Phoenix, AZ 85018-3339 - Phone
- (602) 667-7827
- Fax
- (602) 667-7826
- NPI assigned
- Dec 20, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Stephen Mitchell McNamee, CP
- Title
- Owner
- Phone
- (602) 667-7827
Member organizations 1
Practitioners 3
-
Ray Dolberry, BOCPO
-
Stephen Mitchell McNamee, CP BOCO
-
Kaitlin Quan, CPO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930058938 | AZ | DME Supplier - Prosthetic Personnel |
4385755164 | Practice locations: Phoenix, AZ |
National Provider Directory
Locations
1131 E Highland Ave
Phoenix, AZ 85014
Phone (602) 667-7827
4501 N 32nd St
Phoenix, AZ 85018
Phone (602) 667-7827
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | Yes |
Addresses
Primary practice location
4501 N 32ND St
Phoenix, AZ 85018-3339
Mailing address
1131 E Highland Ave
Phoenix, AZ 85014-3639
Phone (602) 667-7827
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265616643 | Medicaid | AZ |
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All providers in Phoenix, AZ · Prosthetic/Orthotic Supplier in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.